POS1226 CLINICAL FACTORS ASSOCIATED WITH A POSITIVE SARS-CoV-19 TEST AND WITH FREQUENT TESTING DURING THE COVID-19 PANDEMIC IN &gt;10.000 PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES. RESULTS FROM A NATIONWIDE SURVEY FROM THE DANISH DANBIO REGISTRY
Authors: B. Glintborg, D. V. Jensen, L. Terslev, O. Hendricks, M. Østergaard, S. H. Rasmussen, M. Pfeiffer-Jensen, T. Adelsten, A. Colic, K. Danebod, M. Kildemand, A. G. Loft, H. L. Munk, J. K. Pedersen, R. Østgård, C. M. Sørensen, N. Steen Krogh, J. Nørgaard Agerbo, C. Ziegler, M. L. Hetland
Journal: Annals of the Rheumatic Diseases (2022)

Background Patients with inflammatory rheumatic diseases (IRD) have used self-isolation and social distancing during the pandemic to avoid SARS-CoV-19 infection (reference). In countries with unlimited and free access to SARS-CoV-19 testing, anxiety or other patient related factors might potentially increase test-frequency. Objectives In patients with IRD followed in the nationwide DANBIO registry we aimed to explore clinical factors including self-isolation associated with a) a positive SARS-CoV-19 test result (‘infection’), b) higher frequency of SARS-CoV-19 testing during the first 1½ year of the pandemic. Methods In May-June 2020, IRD patients followed in the quality registry, DANBIO (n=36,152), were invited to participate in the voluntary online questionnaire survey ‘You and your rheumatic disease during times with corona-virus’. Patient characteristics, treatment and patient reported outcomes were captured in DANBIO and from the questionnaire. Patients were considered as self-isolating if they agreed to the question: I stay at home and avoid others as much as possible. After written consent, information on dates and SARS-CoV-19 test results (by PCR, polymerase chain reaction) during follow-up (until Nov 2021 and thus before entry of the Omicron variant) was obtained through linkage to the nationwide laboratory system. Time to first positive PCR and associated characteristics were explored by multivariable Cox regression analyses with hazard ratios, HR, adjusted for: gender/age-group/ diagnosis/biologic therapy/working/ self-isolation/HAQ/EQ-5D. Day 0 was defined as the date of first positive test in cohort (May-07-2020). Number of SARS-CoV-19 tests (median (IQR)), and characteristics associated with higher test frequency (upper quartile) was explored with multivariable logistic regression analyses (odds ratios, OR, adjustment like above). Results In 10,098 included patients, 2.8% were infected during follow-up (Table 1). Age and HAQ seemed lower in infected (Table 1, Figure 1). In multivariable Cox regression analyses, male gender was associated with higher infection risk (HR 1.38 (1.05;1.80) whereas risk was lower in the age-group 61-80 years (0.60 (0.39;0.92) vs. below 40 years). Other factors were statistically insignificant. Table 1. Total population SARS-CoV-19 tests Number of tests POSITIVE* NEGATIVE &lt;9 ≥9 Patient number 10,098 282 9816 7406 2692 Patient % 100 3 97 74 26 Female, % 6654 3 97 72 28 Male, % 3444 3 97 77 23 Age, yrs, median (IQR) 61 (51-70) 56 (47-55) 61 (51-70) 55 (47-61) 64 (54-72) Age, strata, yrs &lt; 40 969 4 96 62 38 40-60 3898 4 96 59 41 61-80 4984 2 98 85 15 &gt;80 247 1 99 97 3 Diagnosis AxSpA 1464 4 96 66 34 RA 6345 2 98 76 24 PsA 1689 3 97 70 30 Other 600 4 96 79 31 Biologic treatment, yes** 3831 3 97 72 28 HAQ, median** 0.5 0.375 0.5 0.375 0.5 EQ-5D, median 0.8 0.8 0.8 0.8 0.8 Self-isolating, yes 8474 3 97 74 26 Working 4616 4 96 58 42 Row percentage unless otherwise shown * At least one positive PCR before Nov 2021 **May 2020 AxSpA: Axial spondyloarthritis, EQ-5D: EuroQol quality of life (5D), HAQ: health assessment questionnaire, IQR: interquartile range, PsA: psoriatic arthritis, RA: rheumatoid arthritis Median number of PCR tests was 4 (IQR 1-9). In patients with &lt;9 tests, 2.6% were infected whereas for patients with ≥9 tests, 3.2% were infected. Patients with ≥9 tests were younger, more frequently female and working in univariate (Table 1) and adjusted analyses, whereas other characteristics were statistically insignificant (details not shown). Conclusion Few patients with IRD were infected during the first 1½ years of the pandemic. Gender and age were associated with infection risk and frequency of testing. Self-isolation and a range of other clinical characteristics had no impact, which to some extent may be due to behavioral differences across age-groups. References [1]Glintborg B et al, RMD open, 2021 Disclosure of Interests Bente Glintborg Grant/research support from: AbbVie, BMS, Pfizer, Dorte Vendelbo Jensen: None declared, Lene Terslev Speakers bureau: Roche, Novartis, Pfizer, UCB, Janssen, Oliver Hendricks Grant/research support from: AbbVie, Novartis, Pfizer, Mikkel Østergaard Speakers bureau: Abbvie, BMS, Celgene, Merck, Novartis, Grant/research support from: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Galapagos, Gilead, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi and UCB, Simon Horskjær Rasmussen: None declared, Mogens Pfeiffer-Jensen: None declared, Thomas Adelsten: None declared, Ada Colic: None declared, Kamilla Danebod: None declared, Malene Kildemand: None declared, Anne Gitte Loft Speakers bureau: AbbVie, Eli-Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Heidi Lausten Munk: None declared, Jens Kristian Pedersen: None declared, René Østgård Speakers bureau: Abbvie, BMS, Boehringer-Ingelheim, Eli-Lilly, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi and UCB, Grant/research support from: AbbVie, Christian Møller Sørensen: None declared, Niels Steen Krogh: None declared, Jette Nørgaard Agerbo: None declared, Connie Ziegler: None declared, Merete Lund Hetland Grant/research support from: AbbVie, Biogen, BMS, Celtrion, Eli Lilly Denmark A/S, Janssen Biologics B.V, Lundbeck Fonden, MSD, Pfizer, Roche, Samsung Biopis, Sandoz